Many mistakes in taking medication

Errors in the treatment with drugs especially common

04/01/2015

Drug treatment is the most error-prone part of medical care, and it is not uncommon for patients to face life-threatening consequences in the event of a medication failure. The University Hospital Frankfurt has therefore developed a concept for the systematic avoidance of errors in the medication, with which the drug safety is to be increased significantly at this point.

According to the University Hospital of Frankfurt, the ingestion of wrong medicines and errors in dosage are relatively common in medical practice and pose a serious threat to patients. „National and international studies conclude that around 80 percent of all treatment errors in hospitals happen during medication - with sometimes life-threatening consequences“, so the message from the University Hospital. With the newly developed, pioneering concept for the optimization of drug safety, patient safety could be significantly improved in the future, reports Professor Jürgen Schölmerich, medical director and CEO of the University Hospital. The concept can also be transferred to other clinics.

Medication most error-prone part of the medical care
The problem of medication errors has long been known in the art as a potential weak point of therapeutic care. For example, with the support of the Federal Ministry of Health, the Federal Institute for Drugs and Medical Devices (BfArM) has started a research project at the end of last year, with one year study at the university clinics in Bonn, Fürth and Ulm „All patient emergency referrals are (are) investigated to determine whether they were caused by errors in the prescribing or use of medicines.“ In this way, the researchers at the BfArM want to gain new insights into the extent and causes of the medication errors, not least in order to develop improved strategies for their avoidance.

500,000 emergencies annually due to wrong medication
So far, according to the BfArM, there are only a few data available on the frequency and the specific causes of medication errors in outpatient and inpatient care in Germany. It is estimated that around 500,000 hospital emergency admissions per year across Germany are caused by adverse drug reactions due to preventable medication errors. Around Here „reliable representative and frequency-related data from practice“ The research team around Prof. Dr. Julia Stingl, Vice President of the BfArM, over the period of one year, the causes of emergency referrals to the three mentioned clinics. Thus, the importance of medication errors in the context of the practical use of medicines should be better assessed.

Patients themselves can contribute to improving safety
At the University Hospital Frankfurt, the working group for the improvement of drug safety was already launched in 2013. The solutions developed to date include safeguards for the purchase of medicines, the prescription and administration of medicines, according to the University Hospital's announcement. Most recently, patient information on the safety of drug therapy was published in March 2015. The brochure should alert patients to this, „that they themselves can contribute to the safety of their drug therapy“, explains Prof. Sebastian Harder, clinical pharmacologist and chair of the Drug Commission at the University Hospital Frankfurt. By providing comprehensive checklists for the patients, for example, they can control their behavior and avoid mistakes. In addition, the brochure contains a variety of tips for preventing errors in the medication. This begins with small steps, for example by checking the correct spelling of one's name in order to prevent possible confusion, the university hospital continues.

Methodical recording of treatment errors
For the successful avoidance of errors is according to data of the university hospital Frankfurt first „a methodical recording of already occurred errors is required.“ In the system, near-misses should also be registered. For this purpose, the University Hospital is currently introducing a Critical Incident Reporting System (CIRS), which enables employees of the hospital to report critical events and near-misses anonymously. Above all, such a system is essential because the majority of inadvertent actions are without consequences, but could be essential for future cases. The anonymity should ensure that the users of the system have no negative consequences to fear and thus increase the acceptance of the CIRS.

Likelihood of confusion due to similar packaging and names
In order to avoid medication errors in everyday clinical practice, the Medication Safety Working Group at the University Hospital Frankfurt also has one „Checklist for drug therapy safety in the hospital“ Developed. Since, for example, similar-looking and sounding medicines can easily lead to confusion, according to the announcement of the university hospital with the manufacturers was working to minimize the likelihood of confusion of drugs. „As part of the concept for drug therapy safety, we are working with drug manufacturers to ensure that pharmaceutical packaging and spelling are clearly different“, reports Nils Keiner, head of the hospital pharmacy. Already been on this path „extensive improvements towards a clear distinction“ achieved.

Electronic system for the control of the drug prescription
To avoid errors in prescribing and presenting, the University Hospital Frankfurt is also planning to introduce a new electronic system for the prescription of drugs. This should be part of the electronic health record and any newly prescribed drug could be compared with the information available on the health status and other medicines of the patient. In case of potential errors, the system gives an alarm. Critical interactions of the prescribed drugs with each other and possible contraindications are automatically detected in this way. „Further meaningful steps follow and the measures introduced are regularly reviewed so that we can guarantee our patients the highest level of safety in drug therapy“, said Professor Schölmerich. (Fp)